1

Not usually:
Caffeine in the usual dietary dose won't affect an exercise stress test with thallium imaging, but if you ingest caffeine recently you cannot have a stress test with pharmacologic stress using Persantine (dipyridamole), Adenosine or Lexiscan because the caffeine interferes with the metabolism of those agents.
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Caffeine is a stimulant. Recently may have adopted extremely high levels of caffeine which may cause heart palpitations, especially with young people who buy it at the gas stations. This may be dangerous. A regular cup of coffee in am is ok, but not 2 or 3 cups.
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4

Well...:
Since you had a cardiac nuclear scan, I assume your doctors were looking for coronary artery disease. You seem to be a smoker, which makes artery disease worse. So smoking is not a good thing for you, and you should try to stop. Having said that, you are probably not in any more immediate risk for heart problem for smoking after the nuclear exam. Long term risks are greater with smoking.
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8

Cardiac Exam:
Myocardial perfusion imaging looks at blood flow to the left ventricle. This is primarily accomplished using nuclear techniques such as pet or spect using radiotracers such as tl-201, tc-99m, or n-13 ammonia. When it is done with exercise, the myocardial perfusion scan shows blood flow during exercise, and usually compares that to perfusion at rest in order to evaluate for inducible ischemia.
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10

Radiation...:
Depending on what radiotracer is used, you will be exposed to a small amount of radiation but the benefits of the test should outweigh the risks. Are you having pharmacologic or exercise test? Some of the pharmacologic agents can cause some side effects such as bronchoconstriction but a medication called aminophylline can usually be administered to reverse the side effects.
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11

Cancer risk:
It is important to remember that tests commonly done, such as myocardial perfusion scans, ct scans, and plain xrays, expose you to radiation. It adds up. There is an increased incidence of cancer many years later. We cannot practice medicine without those tests but they should only be performed when absolutely necessary. You should question the need for tests involving radiation exposure.
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12

CAD:
The purpose is to diagnose significant coronary artery disease (CAD). If the scan is positive for ischemic changes in the heart, then you will benefit from aggressive medical treatment, angiographic treatment, or surgery. If the scan is negative (and done properly), your risk for CAD or a significant injury such as a heart attack in the next few years is very low.
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14

No:
Radiation poisoning occurs at exposures of 1000 msv and greater (http://sgoti. Ws/plwzai). The radiation exposure from a myocardial perfusion scan is around 10 msv and has never been shown to be harmful, although it is recommended to only get medical imaging performed when appropriate in order to minimize any theoretical cumulative risks of radiation.
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15

Probably:
At some hospitals, physicians assistants are who is actually present during the study. As these tests usually involve some type of stressing of the heart, it is important that whoever is supervising the test has the knowledge to make the decision that the patient is stable and that it is safe. In most cases, a cardiologist has had some input in that decision even if not there for the test.
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16

None:
There are no common side-effects from the radioisotope. There have been very rare reports of allergy. There is a theoretical, but unproven risk of the radiation inducing a cancer 10 to 20 years later. There also is a theoretical, but unproven risk of radiation myocarditis. The radiation exposure of 1 rem (about 10 msv) has not been shown to be harmful. See http://sgoti. Ws/qmhwh7.
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17

Complete imaging:
The heart is a 3 dimensional structure and the images are 2 dimensional. To completely visualize the entire heart, you need more than one view. Hard to fully describe the moon without flying around to the back side.
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19

Small exposure:
The doses of radiopharmaceuticals used for these scans are usually relatively low dose. However thallium (half life 2.7 days) gives more radiation than technetium sestamibi (half life 6 hrs).Radiation reduction depends mainly on two factors time and distance. If you do not stay close to child for prolonged time then radiation exposure is reduced. Growing children more sensitive to radiation.
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21

Indeed:
However it would be a good idea to ask your cardiologist for a letter attesting to your test, the time, the isotope used, the half-life of that isotope, etc. The most commonly used isotope is technitium sestamibi 99 which has a half-life of only 6 hours, however when this radioactive isotope is in short or limited supply, thallium is often substituted, which has a half life of over 73 hours.
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22

Imaging myocardium:
Myocardial perfusion scan is usually injection of radioactive tracer either thallium 201 or tc99m sestamibi. Imaging usually consists of stress, exercise on treadmill or drug induced stress, and then resting phases. Both are imaged and compared looking for areas of permanent damage, infarction, or areas of ischemia, reversible defects in perfusion.
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23

Yes:
Yes, patients with implanted pacemakers have nuclear stress tests/myocardial perfusion scans. The EKG portion of the test will reflect the pacemaker (and likely a left bundle branch block) but reversible ischemia can still be detected in the scans.
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24

Stress test:
It is paramount that the patient is completely still when undergoing myocardial perfusion scanning -- therefore if the myoclonic dystonia is well controlled then you could probably have the scan -- otherwise you have other option of stress and imaging modality.
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25

Immediately:
There are no contraindications to visiting a person with a pacemaker after you had a nuclear stress test. You can visit them anytime as the radiation does not effect the pacemaker.
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26

Blood Perfusion:
The angiogram shows anatomic blockage of coronary arteries. The myocardial perfusion scan shows blood flow to the heart. Blood flow can get past large blockages (shown on angiography) if there are enough small, collateral vessels present.
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